Contreras M, Barbara J A, Anderson C C, Ranasinghe E, Moore C, Brennan M T, Howell D R, Aloysius S, Yardumian A
North London Blood Transfusion Centre, Colindale, UK.
Lancet. 1991 Mar 30;337(8744):753-7. doi: 10.1016/0140-6736(91)91370-a.
To see whether the introduction of screening tests for post-transfusion non-A, non-B hepatitis (NANBH) in the UK would be worth while, the incidence of such hepatitis was assessed among patients receiving blood during operations at five hospitals served by the North London Blood Transfusion Centre. 387 patients, who each received blood or blood components from an average of 3 donors were followed up prospectively and blood samples were taken every 2 weeks for 3 months and then each month for a further 3 months. 229 patients also provided a sample at 12 months. All available patient and donor samples were tested for alanine aminotransferase concentrations and for antibody to hepatitis C virus (anti-HCV) by ELISA. Repeatedly anti-HCV positive samples were submitted to supplementary HCV assays. 1 of the 387 patients showed biochemical evidence of acute post-transfusion NANBH after exclusion of non-viral causes. Anti-HCV developed in this patient and the seroconversion was confirmed by recombinant immunoblot assay and polymerase chain reaction. Serum from 1 of the 8 donors whose blood he received was positive for anti-HCV by all three methods. In another patient HCV seroconversion was shown by ELISA but alanine aminotransferase concentrations remained normal throughout follow-up. His samples and those of his 2 donors were negative for HCV by the polymerase chain reaction. A third patient showed rises in alanine aminotransferase compatible with post-transfusion NANBH, but serology and polymerase chain reaction assays for HCV were negative for her samples and those of her donors. Anti-HCV reactivity likely to be false positive (negative by both confirmatory tests and no adverse effects in recipients) was seen in 6 of 1283 donors. This study, despite its being carried out in the part of the UK with the highest frequency of infectious markers in blood donations, has shown a very low incidence of post-transfusion NANBH.
为了确定在英国引入输血后非甲非乙型肝炎（NANBH）筛查试验是否值得，在由北伦敦输血中心供血的五家医院中，对手术期间接受输血的患者中此类肝炎的发病率进行了评估。对387名患者进行了前瞻性随访，这些患者平均每人接受来自3名供血者的血液或血液成分，每2周采集一次血样，持续3个月，然后每月采集一次，再持续3个月。229名患者还在12个月时提供了一份血样。所有可得的患者和供血者血样均通过酶联免疫吸附测定法检测丙氨酸转氨酶浓度和抗丙型肝炎病毒抗体（抗-HCV）。多次抗-HCV阳性的血样进行补充丙型肝炎病毒检测。在排除非病毒原因后，387名患者中有1名出现输血后急性NANBH的生化证据。该患者出现了抗-HCV，通过重组免疫印迹测定法和聚合酶链反应确认了血清转化。他所接受血液的8名供血者中有1名的血清通过所有三种方法检测抗-HCV均为阳性。另一名患者通过酶联免疫吸附测定法显示丙型肝炎病毒血清转化，但在整个随访期间丙氨酸转氨酶浓度一直正常。他的血样及其2名供血者的血样通过聚合酶链反应检测丙型肝炎病毒均为阴性。在1283名供血者中有6名出现可能为假阳性的抗-HCV反应性（两种确证试验均为阴性且受血者无不良反应）。尽管这项研究是在英国献血中感染标志物出现频率最高的地区进行的，但已显示输血后NANBH的发病率非常低。
